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Initial Treatment Dosages for Severe Deficiency Adults with severe vitamin B12 deficiency often start with higher doses

Patients should be informed of the pros and cons of oral versus parenteral therapy, and regardless of the form of treatment, those with pernicious anemia or malabsorption should be reminded of the need for lifelong replacement

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They make clinical sense when managing documented metabolic adaptation, addressing specific complaints of profound fatigue on GLP-1s, or when gastrointestinal side effects prevent the use of standard therapies

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